This version of the State EMS Forms was posted on this site on 7/9/2010, and revised by the state on 1/07/2009. 

Utah has been submitting 100% of the required data elements to NEMSIS since December 2007. There are 83% of the states agencies submitting 100% of their runs.

Utah's NEMSIS/POLARIS deployment status as of May 12, 2010:

• Agencies live: 117 of 139 (83%)
• Hospitals trained and live: 35 of 46 (76%)

Prehospital OnLine Active Reporting Information System (POLARIS) is Utah's new prehospital data collection system that supports EMS agencies' efforts to comply with the data reporting requirement in Utah Administrative Rule R426-7. POLARIS is the successor to Automated Incident System (AIS), a DOS-based system that was used since the mid-1980s. POLARIS is a web-based system that will run on any computer with a web browser and an Internet connection.

Utah committed to and developed a NEMSIS-compliant prehospital data system to begin providing data to the national NEMSIS data repository by the end of 2007. POLARIS will serve as our NEMSIS-compliant state data repository and also provide a data collection interface that will be available free of charge to all EMS agencies in the state. For the latest information follow link to:

Prehospital OnLine Active Reporting Information System Deployment/Development

Click on the thumbnails below to view a full sized image.

Utah Short Form Template - Critical Data Elements

Select the following to view a printable Acrobat (.PDF) version. 

POLARIS User Manual v1.1 rev 01/2007 (.PDF, 3310.45k)

POLARIS User Manual v1.4 rev 01/2009 (.PDF, 2245.97k)

POLARIS User Manual v1.5 rev 04/2009 (.PDF, 954.96k)

List of National, Utah and Local option NEMSIS Elements List 8/2007 (.xls,71.50k)

List of National, Utah and Local option NEMSIS Elements List 4/2008 (.xls,109.00k)

List of National, Utah and Local option NEMSIS Elements List 1/2009 (.xls,111.00k)

Utah Critical Data Elements List for Short Form 3/2008 (.xls,23.50k)

Click on the following links to view the corresponding files:

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